Clothing and Eczema

An early observation about eczema was that wool clothing was often very irritating and would cause itch in patients with atopic dermatitis. It raises an interesting question: could other materials actually be helpful in treating eczema?

Cotton clothing is commonly recommended for its softness and breathability, but a number of interesting studies suggest there may be potentially superior alternatives.

Silk is perhaps the opposite of wool in terms of softness and smoothness, and, in 2006, a study of 46 children with eczema found a significant decrease in eczema severity in those wearing a special type of silk clothing. Silk is thought to aid wound healing by enhancing collagen synthesis and reducing inflammation.

There are several additional studies of silk-based clothing on eczema, including one that compared it cotton clothes PLUS a topical steroid. In that small study, they found that the silver clothing was essentially as good as the cotton clothes plus topical steroid, which was pretty exciting. A commentary came out on that paper and pointed out that it was too small to be able to make such a bold claim, and that further research must be done.

Silver-coated clothing was also much talked about a few years ago, though I have not heard as much about it recently. Silver-coatings have been shown to have an antibacterial effect on Staphylococcus aureus (staph), an important bacteria in atopic dermatitis that can cause infection and probably fuels the disease just by being present on the skin.

A study compared wearing silver-coated clothing to cotton garments and found that there was a significant improvement of the eczema in the silver-coated group at 1 week, with comparable comfort. Several other studies have also suggested that silver-coated clothing can be helpful in eczema. Some have raised environmental concerns about silver-coated clothing since as it is washed, the silver can end up in the soil and waterways, where it can potentially damage ecosystems.

Although more robust studies need to be done on these textiles, there is promise that we will find features that can potentially make a difference in treating AD, and allow us to minimize or totally avoid the use of medications whenever possible.

4. Vlachou, C., Thomas, K.S., Williams, H.C.: A case report and critical appraisal of the literature on the use of DermaSilk in children with atopic dermatitis. Clinical and experimental dermatology. 34, e901–3 (2009).